When a person is involved in a motor vehicle accident in Michigan, they are almost always entitled to receive critical Michigan no-fault benefits like lost wages and the payment of medical bills. However, to begin the process, the auto insurer responsible for paying will require the injured person to complete an Application for Benefits.
What Is a Michigan No-Fault Claim?
A Michigan no-fault claim, also known as a first-party claim, is a way to unlock and receive essential benefits following an auto accident. These benefits are available to individuals injured in a car accident and include:
Medical Expenses – The car insurance company must pay for all medical bills related to the auto accident not covered by health insurance up to the PIP coverage limit. These expenses include doctors’ visits, physical therapy, rehabilitation, surgery, and other similar medical charges.
Lost Wages – The auto insurance company must pay 85% of gross wages for up to 3 years from the date of the motor vehicle accident. For example, suppose a person earns $1,000 per week from their job but cannot work due to auto accident injuries. In that case, the auto insurance company must pay $850 for that week’s lost income or wage loss.
Household Replacement Services – The auto insurance company must pay $20 per day for household replacement services. These are the household chores you could do before the accident but cannot do anymore because of your injuries. Examples include laundry, vacuuming, dishes, taking out the garbage, mowing the lawn, shoveling snow, cleaning the home, and other household chores.
Attendant Care – Benefits also include the payment of nursing care following a crash. This nursing care can be received either in-home or at a residential facility. Attendant care includes wound care, bathing, dressing, feeding, hygiene, and general supervision. Friends and/or family are allowed to provide nursing care services. The individuals doing the care are entitled to get paid hourly, just like an attending nurse.
Transportation Services – Insurance companies must pay for transportation services to and from medical appointments. This can include private rides, bus rides, Uber, or the use of private transportation companies.
Home Modifications – The insurance company is responsible for outfitting a home following a serious car accident injury. This includes installing a wheelchair ramp, lifts, bathroom facilities, and other accommodations.
Medical Mileage – This benefit includes medical mileage or gas money paid to travel to and from medical appointments.
Prescriptions – The car insurance company must reimburse any prescription drugs and out-of-pocket costs.
How Long Do I Have To Complete the Application for Benefits?
The application for no-fault benefits must be completed and delivered to the auto insurance company within one year of the crash. Failing to do this can result in forfeiting your right to obtain PIP benefits.
Even if you cannot complete an application for benefits, it is essential to provide written notice to the proper auto insurer within one year. The notice must give the name and address of the claimant and indicate in ordinary language the name of the person injured and the time, place, and nature of the person’s injury. MCL 500.3145.
Where Do I File the Application for Benefits?
The application for benefits must be filed with the auto insurance carrier responsible for paying your benefits. Under Michigan law, there is an “order of priority” to determine which auto insurance must pay first-party benefits. The order is the following:
- Your own auto insurance company
- The auto insurance company of a resident relative
- Michigan Assigned Claims Plan – the MACP will assign an insurance carrier to pay up to $250,000 in benefits.
Each insurance company usually has its own application. The application used by Allstate will differ from the one used by Progressive. Ask your attorney or the insurance representative for a blank application.
Below is a detailed explanation of how to complete the benefits application.
How Do I Complete the Application for Benefits?
It is important to complete the application accurately. Insurance companies can use inconsistencies against you later to deny or terminate benefits altogether. As a result, it is essential to contact an experienced no-fault Michigan car accident lawyer to help you complete the application.
General Section:
The first section of most Applications for Benefits asks for background information. Make sure you complete these general questions, including where they ask for a current address, date of birth, phone number, and social security number.
Next, the application will ask for information about the car accident itself. Give the date and time of the accident and the approximate location.
Where it asks for a brief description of the accident do not provide a full narrative on how the accident occurred. Instead, make it short and simple. We suggest you include a copy of the police report prepared following the accident with the application. This will give the insurance company a complete explanation of how the accident occurred.
spouse, or a relative living with you on the accident date. This is very important—make sure you include ALL cars, even if they were not insured or operating at the time of the accident. Include the owner’s name, license plate number, insurance carrier, and policy number.
Medical Section:
After that, the application will ask for all injuries and treatment thus far resulting from the car accident. Again, make sure you include ALL injuries for all parts of the body. Forgetting neck pain or right leg weakness can result in the insurance company declining to extend benefits for treatment related to those injuries at a future date.
The following section is usually about medical treatment. Include the names and addresses of the doctor and/or hospital you visited following the accident. When it asks if you expect more medical treatment, always answer yes. You never know what the future will bring, and it is better to be safe than sorry.
Include your health insurance information, whether it is a private plan (Blue Cross/Blue Shield, HAP) or a government plan like Medicare or Medicaid.
Remember, Medicare or Medicaid don’t pay for auto accident-related medical treatment. However, the car insurance company is still entitled to know your health insurance.
A vital box asks whether or not you “have received any medical treatment for the same or similar symptoms before the accident?” It is essential to be accurate here. If you are reporting low back pain from the accident, and you were treated for low back pain before the accident, mark “YES.” If you are inaccurate in this box, the insurance company will not find you credible and use it to decline benefits in the future.
Lost Wages:
The next section deals with lost wages. If you were employed at the time of the accident, write down the name of your employer, work address, occupation, and start date. Include your weekly salary or hourly wage rate and weekly hours worked. If you were working during the accident, state so because your claim may be covered under a worker’s compensation rather than a no-fault claim.
Do not forget to include when your disability from work began. Often, this is the date of the car accident. If you are still off work when completing the application, include that information in the application.
Important note: Although most Applications for Benefits don’t ask for proof of lost wages, including a few pay stubs from the car accident is a good idea when sending back the application to the car insurance company. That way, they have proof of how much you were earning at the time of the accident, which will speed up the payment of lost wages.
Other Expenses:
Last, there is a small box that asks a very important question: “As a result of your injury, have you incurred any other expenses, such as transportation costs or expenses you would have performed for yourself or your dependents?” This section asks if you have incurred out-of-pocket expenses, transportation costs (medical mileage), replacement services (household chores completed by friends or family), and/or attendant care.
In almost all cases, this box should be marked “YES.” Following a car accident, you will inevitably have at least some out-of-pocket costs. Again, it is better to err on the side of caution.
When answering this question for the application, be brief. There is no need to give an entire narrative about your expenses. Remember, this is just an application, and the insurance will require more proof to pay these benefits anyway.
The End of the Application – Sign and Date
At the end, make sure you sign and date the application where it asks you to. On some applications, you will be asked to sign and date multiple times. Make sure you do this. The last two signatures are authorizations allowing the insurance company to order your medical records and obtain wage loss information. This is fine, and granting the insurance company the right to obtain this documentation will speed up the benefit process.
Michigan First-Party Car Accident Lawyers
The Application for Benefits is an important document. Completing it accurately is very important to ensure the claimant receives the benefits he or she is entitled to in a timely and efficient manner.
The legal experts at the Lee Steinberg Law Firm have been handling first-party claims for over 50 years. Our team of tough and aggressive Michigan car accident lawyers knows what it takes to get you the benefits you paid for and deserve.
Call us at 1-800-LEE-FREE (1-866-696-9146) for a free consultation. We can answer your questions. Our office will go after the insurance company for your unpaid no-fault benefits. We have collected hundreds of millions of PIP benefits for our clients. And we never charge anything until we win your case.